10 ms·
On being sane in insane places (1973) [pdf]
- dbgrman 8mo agoAn experiment where they sent normal people to mental institutes to see if professionals would be able to identify them.
- lostlogin 8mo agoAnd interestingly, how often the patients in the ward could spot these normal people while the medical staff did not.
- tines 8mo agoThis is from the seventies. I wonder if things would be different fifty years later.
- EtienneDeLyon 8mo agoNope! https://archive.is/tH0il https://archive.is/tH0il
- tines 8mo agoThis isn't really the same situation.
- cwmoore 8mo agoThat one is a case of mistaken identity, but the same process, same players, and same system.
- tines 8mo agoThe fact that we're hearing about it means that the process worked, doesn't it?
- cheeseomlit 8mo agoYeah, after he was forcibly injected with drugs against his will. >Mr. Wright said the hospital later apologized to him and gave him a $50 gift card for a restaurant. The crisis center also apologized and gave him a $25 Walmart gift card. That alone would be enough to drive me clinically insane
- tines 8mo agoSure, that was the first responders on the scene. The question isn’t about whether mistakes are made, it’s that once they’re made, will they be recognized and fixed? The commenters article doesn’t show what they claim (if not proving the opposite).
- cwmoore 8mo agoI don’t think you are thinking rationally about the issue. Medical mistakes are significant events, and $75 in gift cards, much less than minimum wage, fixes very little except the consciences of the “mental health providers”.
- cwmoore 8mo agoNo
- clort 8mo agoI'd say yes. I have a book by Lauren Slater, called 'Opening Skinners Box' in which she researched many psychological experiments of the past, and subjected herself to similar conditions where she could, in an effort to understand better. The chapter on 'Thud' ended with her visiting a psychiatric hospital of good reputation with an emergency room, she basically said the same things as the researchers in the paper. She was given some anti-psychotics and sent away. https://en.wikipedia.org/wiki/Opening_Skinner%27s_Box https://en.wikipedia.org/wiki/Opening_Skinner%27s_Box
- blast 8mo ago> She was given some anti-psychotics and sent away But that confirms the main point of the experiment, which was that people who didn't need psychiatric treatment were given it anyway. It's only of secondary importance that the prescribed treatment changed from hospitalization in 1973 to drugs by 2004. The primary point is that there was no objective way to determine who genuinely needed treatment. She didn't, but was diagnosed anyway. This objection is so obvious that she must have addressed it in the book. Do you remember if she did?
- hamdingers 8mo agoI happen to have the book handy. > HERE’S WHAT’S DIFFERENT: I was not admitted. This is a very significant difference. No one even thought about admitting me. I was mislabeled but not locked up. Here’s another thing that’s different: every single medical professional was nice to me. Rosenhan and his confederates felt diminished by their diagnoses; I, for whatever reason, was treated with palpable kindness. Seems she would disagree with your assessment that being prescribed some likely-harmless pills is the same as losing your freedom. There's also a section earlier where she presents an argument the actual finding of the study is that mental healthcare is not set up to handle adversarial or dishonest patients, which is still a problem and a tough one to solve.
- rcxdude 8mo agoMental healthcare does care about dishonest patients in some cases, mainly where it's an avenue for drug-seeking. But no-one's trying to get ahold of anti-psychotics for recreational purposes.
- dbgrman 8mo agoI wonder the same. Have been reading up on literature related to ADD/ADHD diagnosis and prescription stimulants. It seems like there is little to no friction in getting a legit positive diagnosis. One can pretend to have issues securing a medication that is only meant for strong ADHD patients. I know someone who was able to get their hand on a lot of such stimulants, got addicted, went over the typical dosage, and is now suffering from psychosis.
- nephihaha 8mo agoLike I say elsewhere I have visited two people in our local psychiatric unit. I haven't encountered any of the shrinks but the nurses vary a lot in attitude. The whole place is underfunded and I believe most people would become more mentally ill by being kept in this environment, which has little more than a TV to keep people motivated. The only view of the outdoors is through windows and almost no one is allowed to smoke even though this causes immense tension.
- ossicones 8mo agoIf you've ever taken a depression screener at a wellness visit, that's a consequence of this work. This paper describes how unreliable psychiatric diagnosis used to be. There were standards, but they ultimately came down to physician judgment. This created demand for more objective standards, which resulted in the "checklist" approach that we have now.
- dillydogg 8mo agoIt's true. You wouldn't believe how many people I've SIGECAPS'd during my medical training. I didn't realize this article was the beginning of this approach, but it certainly helped get care to people who previously wouldn't have received it. Though I'm sure there are also many who may require intervention that aren't captured by a SIGECAPS exam. The double edged sword of the checklist manifesto, though I overall think it has been beneficial. SIGECAPS is an acronym taught in US medicine for the diagnosis of major depressive disorder: Sleep disturbance, Interest loss, Guilt, Energy loss, Concentration loss, Appetite changes, Psychomotor agitation, Suicidality. And must have Depressed mood or Anhedonia (inability to enjoy things previously enjoyable). The history of the SIG E CAPS acronym is also interesting, I've heard it was short for SIG (old shorthand for "to be prescribed") Energy CAPsules.
- RodgerTheGreat 8mo agoIs "energy capsules" a euphemism for amphetamines?
- dillydogg 8mo agoI was taught that it was more a memory device for recognizing major depressive disorder as a state of sadness and low energy. The treatment, I presume was still SSRIs first line.
- post_break 8mo agoI had to look up SIGECAPS before I read the rest of your comment. Big oof when I did. Never heard of Anhedonia, but I sure have it.
- ameliaquining 8mo agoThis study was a fraud: https://doi.org/10.1177/0957154x221150878 https://doi.org/10.1177/0957154x221150878
- nephihaha 8mo agoI have heard that, however there is truth in the assertions. I know two people currently in psychiatric hospital, with one seeming to be relatively sane just now but trapped in there, and another whose mental health is being affected detrimentally by the hospital environment. I've no doubt the latter could have recovered last year but for the fact she is being kept in an environment where her only contact with the outside world or nature is at the behest of hospital staff (who vary a lot in terms of attitude and even fluency in English).
- 12_throw_away 8mo agoThis is one of those "important research with unbelievably flawed methods" sort of situations. Psych research before IRBs was crazy.
- TZubiri 8mo agoNowadays there's a lot of FUTON bias in research. There's so much power in just hitting the streets or reaching out to your circle. For the most part, you care the most about your circle, so if that isn't representative of the whole of society, it sounds like somebody else's problem. Who said all research needed to be perfect.
- sien 8mo agoTo explain this for anyone else like me who hadn't heard the term. https://en.wikipedia.org/wiki/Open_access_citation_advantage https://en.wikipedia.org/wiki/Open_access_citation_advantage Full Text On the Net = FUTON.
- sddfgvdsvsdfas 8mo ago[flagged]
- sddfgvdsvsdfas 8mo ago[flagged]
- dang 8mo agoCould you please stop posting unsubstantive comments and flamebait? You've unfortunately been doing it repeatedly. It's not what this site is for, and destroys what it is for. Please don't create accounts to do this with. If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful. (We detached this subthread from https://news.ycombinator.com/item?id=46860103 https://news.ycombinator.com/item?id=46860103.)
- sddfgvdsvsdfas 8mo ago[dead]
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- cm2012 8mo agoThis experiment is now widely debated, the author may have made up or exaggerated details.
- ggreer 8mo agoIt's unclear if this experiment actually happened the way Rosenhan claimed. A journalist went through Rosenhan's archives and tried to verify his story. She managed to track down one of the pseudopatients, who disputed some of Rosenhan's claims such as the amount of preparation, and whether Rosenhan had worked out a legal backup plan in case the institution refused to release the patient.[1] She also noted large discrepancies in various numbers. Apparently she wrote a book about the whole thing, but I haven't had the chance to read it.[2][3] 1. https://sci-hub.red/10.1038/d41586-019-03268-y https://sci-hub.red/10.1038/d41586-019-03268-y 2. https://www.npr.org/2019/11/13/777172316/the-great-pretender-investigates-a-landmark-moment-in-psychiatric-history https://www.npr.org/2019/11/13/777172316/the-great-pretender... 3. https://www.susannahcahalan.com/the-great-pretender https://www.susannahcahalan.com/the-great-pretender
- dbgrman 8mo agoThanks for sharing, will read these.
- arcfour 8mo agohttps://spectator.com/article/how-a-fraudulent-experiment-set-psychiatry-back-decades/?edition=us https://spectator.com/article/how-a-fraudulent-experiment-se... Goes over things pretty well - the experiment seems to have been almost completely fraudulent with fabricated or heavily cherry-picked data.
- wumms 8mo agoReminds me of: Man’s Search for Meaning (1946) https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning
- nephihaha 8mo agoWas rereading that last year. Recommend it to anyone who hasn't.
- dang 8mo agoRelated. Others? The Rosenhan Experiment: On Being Sane in Insane Places - https://news.ycombinator.com/item?id=45785783 https://news.ycombinator.com/item?id=45785783 - Nov 2025 (1 comment) On Being Sane in Insane Places (1973) - https://news.ycombinator.com/item?id=32686098 https://news.ycombinator.com/item?id=32686098 - Sept 2022 (2 comments) David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades - https://news.ycombinator.com/item?id=22155529 https://news.ycombinator.com/item?id=22155529 - Jan 2020 (119 comments) Troubling discrepancies in Rosenhan's “On Being Sane in Insane Places”? - https://news.ycombinator.com/item?id=21437852 https://news.ycombinator.com/item?id=21437852 - Nov 2019 (16 comments) On being sane in insane places - https://news.ycombinator.com/item?id=10885181 https://news.ycombinator.com/item?id=10885181 - Jan 2016 (1 comment) On being sane in insane places - https://news.ycombinator.com/item?id=4371212 https://news.ycombinator.com/item?id=4371212 - Aug 2012 (2 comments) Rosenhan experiment (1973) - https://news.ycombinator.com/item?id=1469370 https://news.ycombinator.com/item?id=1469370 - June 2010 (2 comments)
- nibles_and_bits 8mo agoHello from a wildcat alumnus class 2006, never thought I would see a weber state link in HN top 20.
- dbgrman 8mo agolol, that's the first pdf link i could find of this article.
- deleted 8mo ago[deleted]
- nephihaha 8mo agoWe are trained to be scared of lone individuals and rural environments, when in fact most abuses occur within a hierarchy and urban settings. I feel the fatal flaw in human nature is so many are obedient to power without question, especially when power has some kind of uniform, but also within gangs etc. In the hospital environment, power is partly conveyed by the clothes people where and if you do not conform or obey, then you are punished. It is a pattern we are conditioned into from nursery/kindergarten onwards.
- jordwest 8mo agoI think it comes down to a fear of uncertainty. It's comfortable to believe in authority. Authority provides the illusion of a sense of control, predictability, certainty and orderliness, and it's like we gravitate toward that even when it leads to bad outcomes for us. For most of us the fear of being out of control seems to be greater than the fear of being controlled.
- nephihaha 8mo agoI'm not sure it's even uncertainty. Authority carries a bigger stick, and things like witch hunts and burning of heretics and rebel peasants, have deselected independence of mind over the centuries. Society has an unconscious memory of what used to happen when people disagreed. And still does in some places. People today worship the white lab coat and the military/police uniform in the same way their ancestors honoured witch doctors/shamans and the tribe's warriors. They assume the former groups will dish out good advice and the latter will protect them. The general public experiences this in hospitals and schools, with psychiatric hospitals being the most extreme version of hierarchy. I've mentioned that I currently have two friends who are stuck in a mental hospital, and I have told both of them that they need to be respectful of staff if they want to get out sooner. The woman seems to have had her day passes revoked, and been placed on a more secure ward, after being cheeky to staff. Maybe the staff were awful but she isn't in much of a position to negotiate — she's been in there for nine months. (I've heard rumours of one of the other patients being sexually assaulted by staff, but thanks to the nature of these places I don't know whether it is fantasy or a real crime, since the supposed victim is doped up to the eyeballs much of the time and would not remember it properly.)
- TacticalCoder 8mo ago"The normal are not detectably sane" I remember reading an essay explaining that patients not sharing the political beliefs of the physician running the asylum are more likely to be classified as mentally ill. A mental asylum paid by state money is usually going to be in the hand of physicians who never see anything wrong with the state (not biting the hand that feeds you and all that): so when for example a libertarian arrives, he's much more likely to be classified as mentally ill than if a socialist arrives. So it's all arbitrary and, moreover, you better put the odds on your side by trying to determine what are the physicians' political beliefs and pretend you have the same ; )
- readthenotes1 8mo agoGrifters gonna grift. No reason to talk about yet another failure in social sciences https://spectator.com/article/how-a-fraudulent-experiment-set-psychiatry-back-decades/?edition=us https://spectator.com/article/how-a-fraudulent-experiment-se...
- lalith_c 8mo agoeasy solution is to not put yourself in that situation